Foundation University

COLLEGE OF NURSING
Dumaguete City

Nur 205: Care of Clients with Problems in Oxygenation,

Fluid and Electrolytes, Infectious, Inflammatory
and Immunologic Responses, Cellular Aberration,
Acute and Chronic

1. Course Description: This course deals with the principles and techniques of nursing care
management of sick clients across lifespan with emphasis on the adult and the older person,
population group in any setting with alterations/problems in oxygenation, fluid and electrolyte
balance, infectious, inflammatory and immunologic response problems, cellular aberrations,
and acute and chronic problems

Instructor: Judd Wilson T. Pasculado RN

Activities: Case Study on Asthma

Instruction:

Utilize references as many as you can, this is an individual work.

Submit a hand written paper, use long bond paper

Write the question first and please answer in your own words.
Patient Profile
E.S. is a 35-yr-old mother of two school-age boys who arrives via ambulance in the emergency
department (ED) with severe wheezing, dyspnea, and anxiety. She was in the ED 6 hours earlier
with an asthma attack.
Subjective Data
• Treated during previous ED visit with nebulized albuterol and responded quickly
• Allergic to cigarette smoke
• Began to experience increasing tightness in her chest and shortness of breath when she returned
home following her previous ED visit
• Used the albuterol several times after she returned home with no relief
• Diagnosed with asthma 2 years ago
• Does not have a health care provider and is not on any medications
Objective Data
Physical Examination
• Sitting upright and using accessory muscles to breathe
• Talks in one- to three-word sentences
• RR: 34 breaths/min and shallow
• Audible wheezing
• Auscultation of lung fields reveals no air movement in lower lobes
• HR: 126 bpm
• Noted to be extremely anxious and restless
Diagnostic Studies
• ABGs: pH 7.46, PaCO2 36 mm Hg, PaO2 76 mm Hg, O2 saturation 88%
• Chest x-ray: bilateral lung hyperinflation with lower lobe atelectasis
• CBC with differential and electrolytes: within normal limits
An IV is started in her left forearm with normal saline infusing at 100 mL/hr.
Discussion Questions
Using a separate sheet of paper, answer the following questions:
1. What other assessment information should be obtained from E.S.?
2. What are the priority interprofessional team's interventions for E.S.?
3. What data obtained from the brief history, physical examination, and diagnostic studies indicate
that E.S. is experiencing a severe or life-threatening asthma attack?
4. Identify two classifications of medications the nurse should expect to be administered to this
patient. What effect is expected with these medications?
5. In addition to medication administration and close monitoring of the patient, what other key role can the nurse take in
helping the patient through this episode?
6. What value would peak expiratory flow rate (PEFR) measures have during the care of E.S.?
7. What health care teaching should be included for this patient related to her asthma?
8. Based on the assessment data presented, what are the priority nursing diagnoses? What are the collaborative problems?